When "One Size Fits All" Fits None: A Commentary on the Impacts of the"Draft Canadian Breast Cancer Screening Guidelines" on Racialized Populations in Canada.

IF 2.8 4区 医学 Q2 ONCOLOGY
Beverley Osei, Gayathri Naganathan, Juliet M Daniel, Supriya Kulkarni, Aisha Lofters, Yinka Oladele, Leila Springer, Mojola Omole
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Abstract

Epidemiological data show racial and ethnic differences exist in breast cancer morbidity and mortality amongst Black, Indigenous, Asian, and Hispanic populations, with non-white females experiencing earlier age at diagnosis, more aggressive breast cancer subtypes and advanced cancer stages, and earlier mortality than white females. However, the current Canadian breast cancer screening guidelines recommend biannual screening for all females starting from age 50 to age 74 and suggest not to screen individuals aged 40-49. In May 2024, the Canadian Task Force for Preventative Health released updated draft breast cancer screening guidelines, maintaining such recommendations for screening. Both the existing and the proposed guidelines fail to account for the unique cancer burden amongst racialized populations in Canada and risk further perpetuation of existing racial and ethnic disparities by underscreening racialized females. This commentary will present data regarding racial disparities in cancer burden, highlighting the role social and biological factors play in impacting cancer risk and age of disease and presenting perspectives from stakeholder groups reflecting the impacts of current screening guidelines. Ultimately, we critique the current "one-size-fits-all" approach to breast cancer screening in Canada, emphasizing the need for adapted screening practices with the understanding that the current approaches overlook the needs of racialized Canadian populations.

当“一刀切”无刀切时:评论“加拿大乳腺癌筛查指南草案”对加拿大种族化人群的影响。
流行病学数据显示,在黑人、土著、亚洲和西班牙裔人群中,乳腺癌发病率和死亡率存在种族和民族差异,非白人女性比白人女性诊断年龄更早,乳腺癌亚型更具侵袭性,癌症晚期更严重,死亡率更早。然而,目前的加拿大乳腺癌筛查指南建议对50岁至74岁的所有女性每年进行两次筛查,并建议不要筛查40-49岁的个体。2024年5月,加拿大预防健康工作组发布了更新的乳腺癌筛查指南草案,保留了这些筛查建议。现有的和拟议的指南都没有考虑到加拿大种族化人群中独特的癌症负担,并且由于对种族化女性的筛查不足,有可能进一步延续现有的种族和民族差异。本评论将介绍有关癌症负担中的种族差异的数据,突出社会和生物因素在影响癌症风险和疾病年龄方面所起的作用,并介绍反映当前筛查指南影响的利益攸关方团体的观点。最后,我们对加拿大目前“一刀切”的乳腺癌筛查方法进行了批评,强调需要适应筛查实践,因为目前的方法忽视了加拿大种族化人群的需求。
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来源期刊
Current oncology
Current oncology ONCOLOGY-
CiteScore
3.30
自引率
7.70%
发文量
664
审稿时长
1 months
期刊介绍: Current Oncology is a peer-reviewed, Canadian-based and internationally respected journal. Current Oncology represents a multidisciplinary medium encompassing health care workers in the field of cancer therapy in Canada to report upon and to review progress in the management of this disease. We encourage submissions from all fields of cancer medicine, including radiation oncology, surgical oncology, medical oncology, pediatric oncology, pathology, and cancer rehabilitation and survivorship. Articles published in the journal typically contain information that is relevant directly to clinical oncology practice, and have clear potential for application to the current or future practice of cancer medicine.
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